Women Should Have Access to and Coverage for Mammography

Susan G. Komen® believes all women should have access to regular screening mammograms when they and their health care providers decide it is best based on their personal risk of breast cancer. In addition, screening should be covered by insurance companies, government programs and other third-party payers. Read more.

Mammography in women ages 40-49 may save lives, but the benefit is less than for older women. Individual study findings vary [5,22].

The U.S. Preventive Services Task Force meta-analysis combined the results from 8 randomized controlled trials. It found no clear difference in the risk of dying from breast cancer for women ages 39-49 who got mammograms on a regular basis and their peers who did not get mammograms [22]. If there was any difference, it was likely very small.

Benefits and risks of mammography for women ages 40-49

There are a few reasons why mammography offers less benefit for younger women than for older women [23]:

Women ages 40-49 have a lower risk of breast cancer than older women.

Younger women tend to have dense breast tissue, which can make abnormal findings hard to see on a mammogram.

Breast cancers in younger women tend to grow faster than breast cancers in older women. This means mammography every 1-2 years may be less likely to catch breast cancers in younger women early, when the chances of survival are highest.

For younger women, there are also some drawbacks of screening mammography.

One drawback is a high rate of false positive results (when a screening test shows there's cancer when in fact, cancer isn't present).

Because so few breast cancers occur in young women, those who get mammograms are more likely than older women to have a false positive result. This means they'll be told they have an abnormal finding and undergo follow-up tests only to find they don't have breast cancer. Follow-up tests may include further mammograms, breast ultrasounds or even biopsies.

Why are there different screening recommendations for women ages 40-49?

Some major health organizations have concluded the modest potential benefits of mammography for women in their 40s outweigh the risks of false positive results, over-diagnosis and over-treatment [8,13].

The National Comprehensive Cancer Network recommends routine mammography for women starting at age 40 [8]. The American Cancer Society recommends starting at age 45 [13].

Weighing the benefits and risks, the U.S. Preventive Services Task Force does not recommend routine mammography for all women 40-49 [12].

Instead, the Task Force, as well as the American College of Physicians, recommends women 40-49 discuss the pros and cons of mammography with their health care providers. Then, together, make informed decisions about when to start mammography screening and how often to get screened [12,24].

The U.S. Preventive Services Task Force recommends mammography every 2 years for women ages 70-74 [12]. However, it feels there’s not enough scientific evidence to recommend for or against routine mammography screening in women ages 75 and older [12].

Breast cancer risk increases with age, and mammography doesn’t appear to be less effective in women 70 and older.

Many major health organizations, including the American Cancer Society, recommend women ages 70 and older continue to get mammograms on a regular basis as long as they are in good health [8,12,25].

Some women may stop routine breast cancer screening due to poor health. Women who have a serious health problem may not benefit enough from having breast cancer found early to justify screening.

However, women who are in good health and could benefit from treatment (if breast cancer were found) should continue to get mammograms.

If you aren’t sure whether you should continue getting mammograms, talk with your health care provider.